Is Addiction Hereditary?

Disease can be woven into your DNA — and that includes the disease of drug addiction.

About half of your susceptibility to developing a substance use disorder (SUD) can be hereditary. Genetics can mark you as more prone to use alcohol, tobacco products or drugs such as cocaine, heroin and opioids.

But does that mean your chance of addiction is essentially a coin flip if you have a family history of SUD? It’s a little more complicated than that, says addiction psychiatrist Akhil Anand, MD.

How much of addiction is genetic?

Thinking of addiction as genetic begins with understanding that addiction is a chronic relapsing brain disorder. “In many ways, it’s no different than having a family history with heart disease or diabetes,” says Dr. Anand.

Research shows that genetics have somewhere between a 40% and 60% influence on addiction.

Are there addiction genes?

The genetic connection to addiction comes through inherited levels of dopamine, a neurotransmitter made in your brain. Think of dopamine as your brain’s reward center. Basically, it acts as a “feel-good” hormone.

High levels of dopamine can fuel poor impulse control and tilt someone toward addictive behaviors.

“Now, that doesn’t mean that if you have the genes, or if you have family members that have struggled with addiction, that you’re going to develop an addiction,” explains Dr. Anand. “It just means you’re more prone to it.”

In other words, genetics indicate a predisposition — not a destiny.

Addiction: Genetic vs. environmental factors

Clearly, your family tree isn’t the sole indicator of addiction risk. The world around you also can play a significant role in opening a door that leads to problematic substance use, notes Dr. Anand.

Environmental factors that could contribute to addiction include:

• Easy access to a substance. You can’t try what you don’t have, right? Studies show that availability and exposure to substances in the home — particularly at a young age — can drive future use.
• Peer pressure. Friends can serve as a major force when it comes to drinking, smoking or drug use. The desire to “fit in” can lead to increased use and eventual addiction.
• Traumatic stress. There’s a strong connection between exposure to traumatic events and substance abuse, reports The National Child Traumatic Stress Network. 

Additional risk factors

The following groups also have an increased risk of developing a substance use disorder:

• People with mental health issues. Conditions such as bipolar disorder, post-traumatic stress disorder (PTSD) and depression often accompany SUDs.
• Members of the LGBTQIA+ community. The elevated risk is tied to increased levels of trauma and stress, with substance abuse used as a coping mechanism for discrimination and violence.

What does it all mean?

For starters, there isn’t a single path to addiction. Anybody can develop an SUD, and they can do it for any number of reasons in their life. “There’s no simple answer or explanation,” says Dr. Anand.

If you have a family history of SUD, there are steps you can take to reduce your risk. These include:

• Limiting (or avoiding) the use of alcohol, tobacco or other substances.
• Talking to your doctor about your family’s substance use history so they have a full understanding of your genetic predispositions.
• Talking to a therapist.

“While your genes may make you more susceptible to addiction, that is not a fated outcome,” says Dr. Anand. “But understanding your potential risks and taking action on them can help avoid adding to your family’s history of substance use.”

To hear more from Dr. Anand on this topic, listen to the Health Essentials Podcast episode, “How to Help Someone with an Alcohol Addiction.” New episodes of the Health Essentials Podcast publish every Wednesday.